Provider Demographics
NPI:1992402366
Name:YOUNG, EDO (DOULA)
Entity type:Individual
Prefix:
First Name:EDO
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3007 STOCKTON ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-3549
Mailing Address - Country:US
Mailing Address - Phone:571-253-9591
Mailing Address - Fax:
Practice Address - Street 1:3007 STOCKTON ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-3549
Practice Address - Country:US
Practice Address - Phone:571-253-9591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No171400000XOther Service ProvidersHealth & Wellness Coach